(871) Hypertensive Disorders and Perinatal Outcomes During Periviability

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: The objective of this study is to determine the association between hypertensive disorders (HTNP) including chronic hypertension, gestational hypertension, pre-eclampsia with and without severe features, and HELLP syndrome and incidence of neonatal chronic lung disease.

Study Design: We performed a retrospective chart review of periviable deliveries (22w0d to 25w6d gestation) at a tertiary teaching institution from 2013 to 2022. Our exclusion criteria included pregnancy termination, fetal anomalies, or undesired neonatal resuscitation. The exposure (HTNP) in this study included chronic hypertension, gestational hypertension, pre-eclampsia with and without severe features, and HELLP syndrome. The primary outcome was incidence of neonatal chronic lung disease. Univariate analysis was done with Mann-Whitney and Chi-squared tests as appropriate. A logistic regression model was used to study the association of our outcome and our exposure. Adjusted odds ratio (aOR) and 95% confidence intervals were reported. Statistical analysis was performed using IBM SPSS Statistics Version 27.

Results: We analyzed 230 periviable neonates delivered at our institution. Of the analyzed deliveries, 49 (21.3%) were affected by HTNP, while 181 (78.7%) were unaffected. Baseline characteristics are presented in Table 1. Among the neonates who were discharged from the hospital alive, the incidence of neonatal chronic lung disease was 85.3% in pregnancies affected by HTNP, whereas the incidence of neonatal chronic lung disease was 75.9% in pregnancies without HTNP. After logistic regression, the diagnosis of HTNP was associated with neonatal chronic lung disease (aOR 3.21, 95% CI 1.28-11.32).

Conclusion: The presence of hypertensive disorders during periviability may be associated with an increased risk of neonatal chronic lung disease. In the wake of legislative changes leading to increasingly restrictive access to pregnancy termination, these findings may help guide perinatologists when counseling patients about their reproductive options.

Primary & Presenting Author(s)

Peeraya S. Sawangkum, MD (she/her/hers)
Maternal-Fetal Medicine Fellow
University of South Florida
Tampa, Florida, United States

Coauthor(s)

JR
Jared Roeckner, MD
University of South Florida
Tampa, Florida, United States
Viviana de Assis, DO
Maternal Fetal Medicine Fellow
University of South Florida
Tampa, Florida, United States
Katherine Pressman, MD
Resident Physician
University of South Florida
Tampa, Florida, United States
Jose R. Duncan, MD
Assistant Professor
University of South Florida
Tampa, Florida, United States